Abstract

A CASE REPORT ON DICLOFENAC INDUCED ERYTHEMA MULTIFORME

Dr. Bejjanki Amrutha*, Dr. C.N. Harshitha, Dr. Garsha Anusha and Dr. Andugula Kavya

Abstract

Introduction: Erythema multiforme (EM) is a distinctive hypersensitivity syndrome characterized by skin and mucous membrane lesions. EM shows typical clinical patterns. Based on the severity and the number of mucosal sites involved, the disease has been sub-classified into EM minor and major. Case Report: A 36 years female developed Erythematous rash initially in lower limbs gradually progressed to trunk and upper limbs over duration of 6 days. Patient has a complaint of myalgia & sore throat prior to appearance of rash following 5 days of treatment with Diclofenac. There was history of ankle sprain for which she was prescribed tab Diclofenac by medical practitioner. Characteristic target lesions were present over upper and lower limb and trunk. The Nikolsky sign was negative. Investigations revealed moderate leukocytosis. Diclofenac was stopped and patient was treated with Dexamethasone (4mg/day) over a period of 8 days and then gradually tapered off, chlorphenaramine malate (2mg/day) for 5days, soframycin for local application twice daily. Skin lesions starting healing with in a period of 15days.The rash resolved over 1month. Discussion: Case was diagnosed as Drug induced Erythematous multiforme minor. Conclusion: Prompt identification and withdrawal of the culprit drug and rapid initiating supportive care in an appropriate setting is the mainstay for the management of EM.

Keywords: Erythematous multiforme, Diclofenac, Dexamethasone.